Avaliação das habilidades escolares de crianças com implante coclear

OBJETIVO: avaliar e caracterizar o desempenho escolar de crianças com deficiência auditiva usuárias de implante coclear, entre 9 e 12 anos, assim como, verificar o tempo que a criança leva para acessar a informação fonológica e confrontar estes resultados de acordo com o gênero e série dos participantes. MÉTODO: participaram deste estudo 32 crianças, de ambos os gêneros, freqüentando da primeira a quinta séries do ensino fundamental, regularmente matriculadas no Centro de Pesquisas Audiológicas do Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, na cidade de Bauru/SP. Os instrumentos utilizados foram o Teste de Desempenho Escolar (TDE) e o Teste de Nomeação Automática Rápida (RAN). RESULTADOS: os resultados mostraram que 74% das crianças apresentaram desempenho escolar geral abaixo do esperado, com maior dificuldade na escrita e dentro da média para o tempo que levam ao processar a informação. CONCLUSÕES: concluiu-se que 74% das crianças apresentaram desempenho escolar inferior nas avaliações e que não houve relação entre estes resultados com a nomeação rápida, já que este está dentro da média e é um pré-requisito para a leitura, e os participantes deste estudo apresentam habilidade satisfatória para a leitura.

Bioremediation of PAHs - Limitations and soultions

Introduction 1.1 Occurrence of polycyclic aromatic hydrocarbons (PAH) in the environment Worldwide industrial and agricultural developments have released a large number of natural and synthetic hazardous compounds into the environment due to careless waste disposal, illegal waste dumping and accidental spills. As a result, there are numerous sites in the world that require cleanup of soils and groundwater. Polycyclic aromatic hydrocarbons (PAHs) are one of the major groups of these contaminants (Da Silva et al., 2003). PAHs constitute a diverse class of organic compounds consisting of two or more aromatic rings with various structural configurations (Prabhu and Phale, 2003). Being a derivative of benzene, PAHs are thermodynamically stable. In addition, these chemicals tend to adhere to particle surfaces, such as soils, because of their low water solubility and strong hydrophobicity, and this results in greater persistence under natural conditions. This persistence coupled with their potential carcinogenicity makes PAHs problematic environmental contaminants (Cerniglia, 1992; Sutherland, 1992). PAHs are widely found in high concentrations at many industrial sites, particularly those associated with petroleum, gas production and wood preserving industries (Wilson and Jones, 1993). 1.2 Remediation technologies Conventional techniques used for the remediation of soil polluted with organic contaminants include excavation of the contaminated soil and disposal to a landfill or capping - containment - of the contaminated areas of a site. These methods have some drawbacks. The first method simply moves the contamination elsewhere and may create significant risks in the excavation, handling and transport of hazardous material. Additionally, it is very difficult and increasingly expensive to find new landfill sites for the final disposal of the material. The cap and containment method is only an interim solution since the contamination remains on site, requiring monitoring and maintenance of the isolation barriers long into the future, with all the associated costs and potential liability. A better approach than these traditional methods is to completely destroy the pollutants, if possible, or transform them into harmless substances. Some technologies that have been used are high-temperature incineration and various types of chemical decomposition (for example, base-catalyzed dechlorination, UV oxidation). However, these methods have significant disadvantages, principally their technological complexity, high cost , and the lack of public acceptance. Bioremediation, on the contrast, is a promising option for the complete removal and destruction of contaminants. 1.3 Bioremediation of PAH contaminated soil & groundwater Bioremediation is the use of living organisms, primarily microorganisms, to degrade or detoxify hazardous wastes into harmless substances such as carbon dioxide, water and cell biomass Most PAHs are biodegradable unter natural conditions (Da Silva et al., 2003; Meysami and Baheri, 2003) and bioremediation for cleanup of PAH wastes has been extensively studied at both laboratory and commercial levels- It has been implemented at a number of contaminated sites, including the cleanup of the Exxon Valdez oil spill in Prince William Sound, Alaska in 1989, the Mega Borg spill off the Texas coast in 1990 and the Burgan Oil Field, Kuwait in 1994 (Purwaningsih, 2002). Different strategies for PAH bioremediation, such as in situ , ex situ or on site bioremediation were developed in recent years. In situ bioremediation is a technique that is applied to soil and groundwater at the site without removing the contaminated soil or groundwater, based on the provision of optimum conditions for microbiological contaminant breakdown.. Ex situ bioremediation of PAHs, on the other hand, is a technique applied to soil and groundwater which has been removed from the site via excavation (soil) or pumping (water). Hazardous contaminants are converted in controlled bioreactors into harmless compounds in an efficient manner. 1.4 Bioavailability of PAH in the subsurface Frequently, PAH contamination in the environment is occurs as contaminants that are sorbed onto soilparticles rather than in phase (NAPL, non aqueous phase liquids). It is known that the biodegradation rate of most PAHs sorbed onto soil is far lower than rates measured in solution cultures of microorganisms with pure solid pollutants (Alexander and Scow, 1989; Hamaker, 1972). It is generally believed that only that fraction of PAHs dissolved in the solution can be metabolized by microorganisms in soil. The amount of contaminant that can be readily taken up and degraded by microorganisms is defined as bioavailability (Bosma et al., 1997; Maier, 2000). Two phenomena have been suggested to cause the low bioavailability of PAHs in soil (Danielsson, 2000). The first one is strong adsorption of the contaminants to the soil constituents which then leads to very slow release rates of contaminants to the aqueous phase. Sorption is often well correlated with soil organic matter content (Means, 1980) and significantly reduces biodegradation (Manilal and Alexander, 1991). The second phenomenon is slow mass transfer of pollutants, such as pore diffusion in the soil aggregates or diffusion in the organic matter in the soil. The complex set of these physical, chemical and biological processes is schematically illustrated in Figure 1. As shown in Figure 1, biodegradation processes are taking place in the soil solution while diffusion processes occur in the narrow pores in and between soil aggregates (Danielsson, 2000). Seemingly contradictory studies can be found in the literature that indicate the rate and final extent of metabolism may be either lower or higher for sorbed PAHs by soil than those for pure PAHs (Van Loosdrecht et al., 1990). These contrasting results demonstrate that the bioavailability of organic contaminants sorbed onto soil is far from being well understood. Besides bioavailability, there are several other factors influencing the rate and extent of biodegradation of PAHs in soil including microbial population characteristics, physical and chemical properties of PAHs and environmental factors (temperature, moisture, pH, degree of contamination). Figure 1: Schematic diagram showing possible rate-limiting processes during bioremediation of hydrophobic organic contaminants in a contaminated soil-water system (not to scale) (Danielsson, 2000). 1.5 Increasing the bioavailability of PAH in soil Attempts to improve the biodegradation of PAHs in soil by increasing their bioavailability include the use of surfactants , solvents or solubility enhancers.. However, introduction of synthetic surfactant may result in the addition of one more pollutant. (Wang and Brusseau, 1993).A study conducted by Mulder et al. showed that the introduction of hydropropyl-ß-cyclodextrin (HPCD), a well-known PAH solubility enhancer, significantly increased the solubilization of PAHs although it did not improve the biodegradation rate of PAHs (Mulder et al., 1998), indicating that further research is required in order to develop a feasible and efficient remediation method. Enhancing the extent of PAHs mass transfer from the soil phase to the liquid might prove an efficient and environmentally low-risk alternative way of addressing the problem of slow PAH biodegradation in soil.

Evaluation of alkali flooding combined with intermittent flow in carbonate reservoir

The majority of carbonate reservoir is oil-wet, which is an unfavorable condition for oil production. Generally, the total oil recovery after both primary and secondary recovery in an oil-wet reservoir is low. The amount of producible oil by enhanced oil recovery techniques is still large. Alkali substances are proven to be able to reverse rock wettability from oil-wet to water-wet, which is a favorable condition for oil production. However, the wettability reversal mechanism would require a noneconomical aging period to reach the maximum reversal condition. An intermittent flow with the optimum pausing period is then combined with alkali flooding (combination technique) to increase the wettability reversal mechanism and as a consequence, oil recovery is improved. The aims of this study are to evaluate the efficiency of the combination technique and to study the parameters that affect this method. In order to implement alkali flooding, reservoir rock and fluid properties were gathered, e.g. interfacial tension of fluids, rock wettability, etc. The flooding efficiency curves are obtained from core flooding and used as a major criterion for evaluation the performance of technique. The combination technique improves oil recovery when the alkali concentration is lower than 1% wt. (where the wettability reversal mechanism is dominant). The soap plug (that appears when high alkali concentration is used) is absent in this combination as seen from no drop of production rate. Moreover, the use of low alkali concentration limits alkali loss. This combination probably improves oil recovery also in the fractured carbonate reservoirs in which oil is uneconomically produced. The results from the current study indicate that the combination technique is an option that can improve the production of carbonate reservoirs. And a less quantity of alkali is consumed in the process.

The pre-alpine evolution of the basement of the Pelagonian Zone and the Vardar Zone, Greece

The Pelagonian Zone and the Vardar Zone in Greece represent the western part of the Hellenide hinterland (Internal Hellenides). While the Pelagonian Zone comprises predominantly crystalline basement and sedimentary cover rocks, the Vardar Zone has long been regarded as an ophiolite-decorated suture zone separating the Pelagonian Zone from the Serbo-Macedonian Massif to the east. Felsic basement rocks from both areas, with the main focus put on the Pelagonian Zone, were dated in order to identify the major crust-forming episodes and to improve the understanding of the evolutionary history of the region. The interpretation of the single-zircon geochronology results was aided by geochemical investigations. The majority of the basement rocks from the Pelagonian Zone yielded Permo-Carboniferous intrusion ages around 300 Ma, underlining the importance of this crust-forming event for the Internal Hellenides of Greece. Geochemically these basement rocks are classified as subduction-related granitoids, which formed in an active continental margin setting. An important result was the identification of a Precambrian crustal unit within the crystalline basement of the Pelagonian Zone. Orthogneisses from the NW Pelagonian Zone yielded Neoproterozoic ages of c. 700 Ma and are so far the oldest known rocks in Greece. These basement rocks, which are also similar to active margin granitoids, were interpreted as remnants of a terrane, the Florina Terrane, which can be correlated to a Pan-African or Cadomian arc. Since the gneisses contain inherited zircons of Middle to Late Proterozoic ages, the original location of the Florina Terrane was probably at the northwestern margin of Gondwana. In the Vardar Zone an important phase of Upper Jurassic felsic magmatism is documented by igneous formation ages ranging from 155 to 164 Ma. The chemical and isotopic composition of these rocks is also in accord with their formation in a volcanic-arc setting at an active continental margin. Older continental material incorporated in the Vardar Zone is documented by 319-Ma-old gneisses and by inherited zircons of mainly Middle Palaeozoic ages. The prevalence of subduction-related igneous rocks indicates that arc formation and accretion orogeny were the most important processes during the evolution of this part of the Internal Hellenides. The geochronological results demonstrate that most of the Pelagonian Zone and the Vardar Zone crystalline basement formed during distinct pre-Alpine episodes at c. 700, 300 and 160 Ma with a predominance of the Permo-Carboniferous magmatic phase.

Speziation von Neptunium bei der Migration in Tongestein

Die vorliegende Arbeit wurde im Rahmen eines Stipendiums des interdisziplinärenrnGraduiertenkollegs 826 „Spurenanalytik von Elementspezies: Methodenentwicklung und Anwendungen“, gefördert durch die Deutsche Forschungsgemeinschaft (DFG) und das Land Rheinland-Pfalz, angefertigt. Dabei sollten neue Erkenntnisse über die Wechselwirkung zwischen Neptunium und natürlichem Tongestein mit Hinblick auf die Endlagerung wärmeentwickelnder radioaktiver Abfälle in einem geologischen Tiefenlager gewonnen werden. Auf Grund seiner langen Halbwertszeit von mehr als zwei Millionen Jahren wird Np-237 einen signifikanten Anteil an der Radiotoxizität dieser Abfälle nach Lagerzeiten von mehr als 1000 Jahren haben. Np tritt in Lösung unter umweltrelevanten Bedingungen in den Oxidationsstufen +IV und +V auf. Auf Grund der guten Löslichkeit und daher höheren Mobilität ist Np(V) als die gefährlichere Spezies einzustufen. In den Migrationsstudien wurdernOpalinuston (OPA) aus Mont Terri, Schweiz, als natürliches Referenzmaterial verwendet. Der Fokus dieser Arbeit lag dabei auf der Speziation von Np an der Mineraloberfläche mittels synchrotronbasierter Röntgenabsorptionsspektroskopie (EXAFS/XANES).rnDie Wechselwirkung zwischen Np(V) und OPA wurde zunächst in Batch- und Diffusionsexperimenten in Abhängigkeit verschiedener experimenteller Parameter (u.a. pH, Temperatur, Hintergrundelektrolyt, Einfluss von Huminsäure, Konkurrenz mit U(VI), aerobe/anaerobe Bedingungen) untersucht. Die Untersuchung der Np-Speziation erfolgt zum einen an Pulverproben aus Batch-Experimenten unter aeroben und anaeroben Bedingungen, welche mittels EXAFS-Spektroskopie untersucht wurden. Zum anderen wurden ortsaufgelöste μ-XANES-Messungen an Np-Anreicherungen auf OPA-Dünnschliffen und in Diffusionsproben durchgeführt. Durch Kombination der Spektroskopie mit μ-Rötngenfluoreszenzmapping (XRF) und μ-Röntgenbeugung (XRD) konnten zudem Erkenntnisse über die Elementverteilung von Np und anderen im Opalinuston enthaltenen Elementen sowie über kristalline Mineralphasen im Umfeld von Bereichen erhöhter Np-Konzentration erhalten werden.rnSowohl Sorptionsexperimente als auch die spektroskopischen Untersuchungen zeigten eine teilweise Reduktion von Np(V) zu Np(IV) bei der Wechselwirkung mit OPA. Dabei konnte Pyrit als eine der redoxaktiven Phasen identifiziert werden. In diesem Zusammenhang ist die Bildung schwerlöslicher Np(IV)-Spezies mit Hinblick auf die Endlagerung positiv zu bewerten.

Complication and failure rates in patients treated for chronic periodontitis and restored with single crowns on teeth and/or implants

Objectives: To assess the biological and technical complication rates of single crowns on vital teeth (SC-V), endodontically treated teeth without post and core (SC-E), with a cast post and core (SC-PC) and on implants (SC-I). Material and methods: From 392 patients with chronic periodontitis treated and documented by graduate students during the period from 1978 to 2002, 199 were reexamined during 2005 for this retrospective cohort study, and 64 of these patients were treated with SCs. Statistical analysis included Kaplan–Meier survival functions and event rates per 100 years of object-time. Poisson regression was used to compare the four groups of crowns with respect to the incidence rate ratio of failures, and failures and complications combined over 10 years and the entire observation period. Results: Forty-one (64%) female and 23 (36%) male patients participated in the reexamination. At the time of seating the crowns, the mean patient age was 46.8 (range 24–66.3) years. One hundred and sixty-eight single unit crowns were incorporated. Their mean follow-up time was 11.8 (range 0.8–26.4) years. During the time of observation, 22 biological and 11 technical complications occurred; 19 SC were lost. The chance for SC-V (56) to remain free of any failure or complication was 89.3% (95% confidence interval [CI] 76.1–95.4) after 10 years, 85.8% (95% CI 66–94.5) for SC-E (34), 75.9% for SC-PC (39), (95% CI 58.8–86.7) and 66.2% (95% CI 45.1–80.7) for SC-I (39). Over 10 years, 95% of SC-I remained free of failure and demonstrated a cumulative incidence of failure or complication of 34%. Compared with SC-E, SC-I were 3.5 times more likely to yield failures or complications and SC-PC failed 1.7 times more frequently than did SC-E. SC-V had the lowest rate of failures or complications over the 10 years. Conclusions: While SCs on vital teeth have the best prognosis, those on endodontically treated teeth have a slightly poorer prognosis over 10 years. Crowns on teeth with post and cores and implant-supported SCs displayed the highest incidence of failures and complications.

Arguments for and against a career in surgery: a qualitative analysis

To evaluate arguments given by board-certified surgeons in Switzerland for and against a career in surgery.

DARPins recognizing the tumor-associated antigen EpCAM selected by phage and ribosome display and engineered for multivalency

Designed Ankyrin Repeat Proteins (DARPins) represent a novel class of binding molecules. Their favorable biophysical properties such as high affinity, stability and expression yields make them ideal candidates for tumor targeting. Here, we describe the selection of DARPins specific for the tumor-associated antigen epithelial cell adhesion molecule (EpCAM), an approved therapeutic target on solid tumors. We selected DARPins from combinatorial libraries by both phage display and ribosome display and compared their binding on tumor cells. By further rounds of random mutagenesis and ribosome display selection, binders with picomolar affinity were obtained that were entirely monomeric and could be expressed at high yields in the cytoplasm of Escherichia coli. One of the binders, denoted Ec1, bound to EpCAM with picomolar affinity (K(d)=68 pM), and another selected DARPin (Ac2) recognized a different epitope on EpCAM. Through the use of a variety of bivalent and tetravalent arrangements with these DARPins, the off-rate on cells was further improved by up to 47-fold. All EpCAM-specific DARPins were efficiently internalized by receptor-mediated endocytosis, which is essential for intracellular delivery of anticancer agents to tumor cells. Thus, using EpCAM as a target, we provide evidence that DARPins can be conveniently selected and rationally engineered to high-affinity binders of various formats for tumor targeting.

Early versus delayed surgical treatment in open hand injuries: a paradigm revisited

To date it remains unclear if a delayed surgical treatment of open hand injuries after more than 6 h may be detrimental to outcome. Previous investigations by McLain et al. (J Hand Surg Am 16:108-112, 1980 9), Nylen and Carlsson (Scand J Plast Reconstr Surg 14:185-189, 1991 10) could not find statistical proof of correlation between infection rate and delayed surgical treatment after open hand injuries up to 18 h. The current study was designed to investigate the outcome of early versus delayed surgical treatment after open hand injury.

Effects of Echinaforce® treatment on ex vivo-stimulated blood cells

The herb Echinacea purpurea, also called purple coneflower, is regarded as an immune modulator. This study examined changes in cytokine production in blood samples from 30 volunteers before and during 8-day oral administration with an ethanolic extract of fresh Echinacea purpurea (Echinaforce(®)). Daily blood samples were ex vivo stimulated by LPS/SEB or Zymosan and analysed for a series of cytokines and haematological and metabolic parameters. Treatment reduced the proinflammatory mediators TNF-α and IL-1β by up to 24% (p<0.05) and increased anti-inflammatory IL-10 levels by 13% (p<0.05) in comparison to baseline. This demonstrated a substantial overall anti-inflammatory effect of Echinaforce(®) for the whole group (n=28). Chemokines MCP-1 and IL-8 were upregulated by 15% in samples from subjects treated with Echinaforce(®) (p<0.05). An analysis of a subgroup of volunteers who showed low pre-treatment levels of the cytokines MCP-1, IL-8, IL-10 or IFN-γ (n=8) showed significant stimulation of these factors upon Echinaforce(®) treatment (30-49% increases; p<0.05), whereas the levels in subjects with higher pre-treatment levels remained unaffected. We chose the term "adapted immune-modulation" to describe this observation. Volunteers who reported high stress levels (n=7) and more than 2 colds per year experienced a significant transient increase in IFN-γ upon Echinaforce(®) treatment (>50%). Subjects with low cortisol levels (n=11) showed significant down-regulation of the acute-phase proteins IL1-β, IL-6, IL-12 and TNF-α by Echinaforce(®) (range, 13-25%), while subjects with higher cortisol levels showed no such down-regulation. This is the first ex vivo study to demonstrate adapted immune-modulation by an Echinacea preparation. While Echinaforce(®) did not affect leukocyte counts, we speculate that the underlying therapeutic mechanism is based on differential multi-level modulation of the responses of the different types of leukocytes. Echinaforce(®) thus regulates the production of chemokines and cytokines according to current immune status, such as responsiveness to exogenous stimuli, susceptibility to viral infection and exposure to stress.